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General NPI Number Information
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NPI Number | 1073691200
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Entity Type | Organization
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Legal Business Name | CUMINS THERAPY & FITNESS TRAINING LLC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3308 FRANKLIN ROAD SW
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City | ROANOKE
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State | VA
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Zip | 24014
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Country | US
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Telephone | 540-985-0463
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Fax | 540-985-0464
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Provider Business Mailing Address
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Address Line | 3308 FRANKLIN ROAD SW
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City | ROANOKE
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State | VA
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Zip | 24014
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Country | US
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Telephone | 540-985-0463
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Fax | 540-985-0464
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Authorized Official
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Title or Position | PHYSICAL THERAPIST OWNER
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Name | MR. DAVID KENNETH CUMINS
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Credential | MPT
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Telephone | 540-985-0463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2305202290
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License Number State | VA
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